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Understanding the Prognosis for Multiple Myeloma

Once you receive this diagnosis, you’ll want to know your prognosis – the predicted path of the disease.

The road ahead is different for each person with multiple myeloma, but getting the right care can improve outcomes.

Masterfile

If you’re diagnosed with multiple myeloma, you’ll have plenty of questions: How long can you expect to live with multiple myeloma? Is multiple myeloma curable? What is the survival rate for multiple myeloma? What kind of care do you need to live as long as possible and with the best quality of life?

While there are statistics that give median life expectancy for people with multiple myeloma as a whole, each person’s prognosis will vary. A number of factors influence outcomes, including the stage of the disease, chromosome changes, age, and other medical problems.

The expertise of the oncologist who treats your multiple myeloma may also affect how well you feel and how long you live.

Why Statistics Don’t Tell the Whole Story

Thanks to research advances, the National Cancer Institute estimates that the median five-year survival for people with multiple myeloma has increased from around 25 percent in 1975 to 50.7 percent today. (1)

However, it is not unusual for people with myeloma to live 10 years or more. A small subset of people remain in remission for decades.

Doctors are hesitant to use the word “cure” because multiple myeloma is generally considered incurable. They may, however, use the phrase “functionally cured” to describe prolonged remissions.

The Type of Myeloma You Have Makes a Difference

Some people with multiple myeloma have a form of the disease that progresses very slowly.

Smoldering multiple myeloma (SMM), for instance, is an early-stage cancer that does not produce symptoms. Physicians don’t typically treat SMM, opting instead for regular check-ins. Around 10 percent of people with SMM go on to develop multiple myeloma within five years of diagnosis. (2)

Other people may have an especially tough time battling multiple myeloma because of the genetics of the cells. Certain chromosome changes, such as the loss of a piece of chromosome 17, make multiple myeloma more aggressive and lead to a poorer prognosis.

Physicians may run tests to determine the genetic makeup of myeloma cells as part of the staging process. Once they determine whether a cancer is standard or high risk, they make treatment decisions accordingly. (3)

Finding the Best Treatment for You

Physicians treat multiple myeloma with a wide array of approaches, with more and better options opening up new possibilities.

Someone who does not respond to one drug or drug combination, for instance, may do much better with another.

For people who are healthy enough to undergo the procedure, an autologous stem cell transplant appears to lead to the best prognosis.

A study from the University of California in Davis, published in June 2018 in the Journal of the National Cancer Institute, found that people who received this type of transplant had a significant improvement in survival compared to those who didn’t.

Those who had a transplant decreased their risk of dying by 20 percent. Their median survival was around 73 months, compared to 50 months for people with myeloma who did not have a transplant.

Most older people with multiple myeloma are not even offered a transplant as an option, but the study found that the procedure improved survival in all age groups. (4)

White patients older than 65 have a transplant less than 30 percent of the time; for black patients, the rate is under 15 percent. (5)

Pushing for Better Care When You’re Black

African-Americans have twice the incidence of multiple myeloma as white Americans, accounting for 1 out of every 5 people diagnosed with this cancer.

Yet studies have found that African-Americans are less likely to get the newest therapies and more likely to have delays in treatment.

They are also less likely to participate in clinical trials, which can give people early access to medication that might extend their survival or significantly improve their quality of life.

During a clinical trial of the multiple myeloma drug Ninlaro (ixazomib), for instance, which was approved by the Food and Drug Administration in 2015, black participants accounted for only 13 of the 722 people involved. (6)

Adding to the evidence, a study published in December 2017 in the journal Blood found that people with multiple myeloma who saw a specialist at a National Cancer Institute–designated comprehensive cancer center had better overall survival than those who saw a community oncologist. (9)

The Leukemia & Lymphoma Society urges people with myeloma to seek out a myeloma specialist or a doctor who works in consultation with one.

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